Clinical correlation between irrigation bottle contamination and clinical outcomes inpost-functional endoscopic sinus surgery patients

Kevin C. Welch, Michael B. Cohen, Laurie L. Doghramji, Noam A. Cohen, Rakesh K. Chandra, James N. Palmer, Alexander G Chiu

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: Sinonasal irrigation after endoscopic sinus surgery (ESS) is a common practice, but the role irrigation bottles play in iatrogenic contamination of the operated sinuses is unknown. Therefore, we investigated whether irrigation bottles used postoperatively become contaminated and have any potential association with immediate postsurgical infection and outcomes. Methods: Patients irrigated twice daily after ESS. Bottle cleaning was performed as recommended by the manufacturer. New bottles were distributed at the time of the operation and at each postoperative visit. During postoperative weeks 1, 2, and 4, bottles were cultured. Medical charts were reviewed for the presence of postsurgical infection and changes in management. Results: Twenty post-ESS patients were enrolled and examined at weeks 1, 2, and 4. A total of 51 bottles were collected and cultured. Overall, 15 of 51 (29%) bottles demonstrated bacterial growth when cultured. During the first two collection periods, 10 of 40 (25%) bottles demonstrated bacterial growth when cultured; however, five of 11 (45%) bottles collected at the last postoperative visit demonstrated bacterial growth when cultured. During the study, Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae were frequently recovered during the collection periods. Other organisms isolated included Escherichia coli and Enterobacter spp. Although positive bottle cultures were more common at weeks 2 and 4, no postoperative infections occurred. Conclusions: Irrigation bottles used postoperatively have a measurable incidence of contamination. Contamination rate increases when bottles are used for longer than 1 week, but this does not appear to result in postsurgical infection.

Original languageEnglish (US)
Pages (from-to)401-404
Number of pages4
JournalAmerican Journal of Rhinology and Allergy
Volume23
Issue number4
DOIs
StatePublished - 2009
Externally publishedYes

Fingerprint

Infection
Growth
Acinetobacter baumannii
Enterobacter
Klebsiella pneumoniae
Pseudomonas aeruginosa
Escherichia coli
Incidence

Keywords

  • Chronic sinusitis
  • Contamination
  • Debridement
  • Endoscopic sinus surgery
  • Infection
  • Irrigation
  • Outcomes
  • Saline solution

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Immunology and Allergy

Cite this

Clinical correlation between irrigation bottle contamination and clinical outcomes inpost-functional endoscopic sinus surgery patients. / Welch, Kevin C.; Cohen, Michael B.; Doghramji, Laurie L.; Cohen, Noam A.; Chandra, Rakesh K.; Palmer, James N.; Chiu, Alexander G.

In: American Journal of Rhinology and Allergy, Vol. 23, No. 4, 2009, p. 401-404.

Research output: Contribution to journalArticle

Welch, Kevin C. ; Cohen, Michael B. ; Doghramji, Laurie L. ; Cohen, Noam A. ; Chandra, Rakesh K. ; Palmer, James N. ; Chiu, Alexander G. / Clinical correlation between irrigation bottle contamination and clinical outcomes inpost-functional endoscopic sinus surgery patients. In: American Journal of Rhinology and Allergy. 2009 ; Vol. 23, No. 4. pp. 401-404.
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abstract = "Background: Sinonasal irrigation after endoscopic sinus surgery (ESS) is a common practice, but the role irrigation bottles play in iatrogenic contamination of the operated sinuses is unknown. Therefore, we investigated whether irrigation bottles used postoperatively become contaminated and have any potential association with immediate postsurgical infection and outcomes. Methods: Patients irrigated twice daily after ESS. Bottle cleaning was performed as recommended by the manufacturer. New bottles were distributed at the time of the operation and at each postoperative visit. During postoperative weeks 1, 2, and 4, bottles were cultured. Medical charts were reviewed for the presence of postsurgical infection and changes in management. Results: Twenty post-ESS patients were enrolled and examined at weeks 1, 2, and 4. A total of 51 bottles were collected and cultured. Overall, 15 of 51 (29{\%}) bottles demonstrated bacterial growth when cultured. During the first two collection periods, 10 of 40 (25{\%}) bottles demonstrated bacterial growth when cultured; however, five of 11 (45{\%}) bottles collected at the last postoperative visit demonstrated bacterial growth when cultured. During the study, Pseudomonas aeruginosa, Acinetobacter baumannii, and Klebsiella pneumoniae were frequently recovered during the collection periods. Other organisms isolated included Escherichia coli and Enterobacter spp. Although positive bottle cultures were more common at weeks 2 and 4, no postoperative infections occurred. Conclusions: Irrigation bottles used postoperatively have a measurable incidence of contamination. Contamination rate increases when bottles are used for longer than 1 week, but this does not appear to result in postsurgical infection.",
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